Family Tree Clinic

Presentation Request Form

Thank you for your interest in having Family Tree Clinic educators visit your organization or school. Please fill out the form below and hit submit. We will get back to you as soon as possible to confirm your presentation topic, time, and date.

For detailed information about our education services see our presentation descriptions and meet our educators.

Payment
Each presentation costs an average of $100. We ask for a payment of $75 per class to help offset these costs. However, payment in any amount is welcome, and we will present regardless of ability to pay.

Your Name (required):

Do you have the ability to offset presentation costs?
Yes, we can pay $75 per presentation.No, we don't have the ability at this time.
Yes, we can pay (please enter amount).

School/Organization (required):

Address:

Your Email (required):

Contact Phone:

Phone Type:
cellwork

Preferred contact method:
E-mailcell phonework phone

Class Information
*Please note: Each presentation requires approximately one hour. Family Tree Clinic has three educators. Each educator can provide up to four (4) presentations per day.

Grade/Age level(s):

Number of classes:

Start and end times for each class:

School Presentations
Puberty and AnatomyPregnancy PreventionSexually Transmitted InfectionsSHARP

Community Presentations
Puberty and AnatomyPregnancy PreventionSexually Transmitted InfectionsHealthy RelationshipsSHARP

Adult and Professional Presentations
Parents Are Sexuality Educators (PASE)When Sex Comes Up: How to Talk With Kids About Sex in a Professional SettingSex Positive Sex Ed: What, Why, and How

Do you have an instructor preference?
No PreferenceLindseyTatumJackie

Ideal date range:

Is there any additional information that you would like us to know?